Conflict may seriously impact the health and wellbeing of young people not just through directly experienced trauma such as beatings and the loss of a family member, but also less directly, through economic hardship, constraints on mobility and livelihoods, reduced access to health-related and other goods and services, lawlessness and insecurity, and breakdown of community cohesion and support. These ?stressors? of conflict environments may significantly affect young people?s mental health, their expectations for the future, and their engagement in risk behaviors. In order to appropriately target interventions to mitigate harm to youth, policymakers need information on effects of both trauma and indirect exposure to conflict. However, research on the effects of conflict on young people has largely been limited to consideration of the effects of direct conflict-related trauma on adolescents? mental health. Further, very little research has examined the impacts of conflict (whether through trauma or aspects of the conflict environment) on the future orientation and engagement in health risk behaviors of youth, a group that is especially vulnerable to such behaviors. In this study we test an ecological model of the impacts of conflict on youth that encompasses both the broader conflict environment and direct exposure to violence. We will use unique representative data on Palestinian youth in the Occupied West Bank, an area of pervasive political violence and conflict-related disruptions to normal life. The survey contains information on mental health, risk behaviors (smoking, alcohol and drug use, sexual activity), future expectations, and on direct exposure to violence. We will link the survey with multi-year, geocoded measures of aspects of the conflict environment in the West Bank, including barriers to mobility and events such as demonstrations and home demolitions. These linked data provide a unique opportunity to understand the impacts of conflict environments, as well as direct experience of trauma, while providing specific insight into the vulnerabilities of Palestinian youth living under conflict, and potential measures to mitigate harm.
The Specific Aims are:
AIM1 : Understand the importance of both direct (via trauma) and indirect (environmental) impacts of conflict on young people?s mental health, health risk behavior, and expectations for the future.
AIM2 : Explore the effect of other spatial or environmental factors, including local economic deprivation and unemployment and distance to Palestinian urban centers, on these outcomes.
AIM 3 : Understand the role of changes in future expectations, fatalism, and mental health as potential mediators of the impacts of both direct and indirect conflict exposure on engagement in risk behaviors AIM 4: Explore factors at the individual, family, and community level that may protect against effects of conflict and those that may increase vulnerability?potentially differently for direct and indirect exposure--and make recommendations for policy to mitigate the harmful effects of conflict on youth.
This study will provide evidence on the impacts of conflict environments, as well as of direct experience of conflict-related violence, on the mental health and risk behaviors of Palestinian youth. Understanding how young people are affected by both kinds of exposure to conflict, and the factors that may moderate impacts, will assist in the design and appropriate targeting of interventions to mitigate harm to youth. The findings should have public health relevance to a wide range of contexts where young people are exposed to protracted political conflict and associated disruptions to normal life.
